HOW TO CHOOSE A DOCTOR

In Ideal Partnership


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The world of Roman medicine was completely unregulated, and doctors were free to practice without any form of standardized accreditation. In towns and villages, it was easy to know if a healer was effective or not as word would spread quickly enough through smaller communities. But the bustling metropolis of Rome offered the potential for anonymity. There was palpable anxiety about the quality of doctors and concern that greedy charlatans could evade detection, even if their treatments were deadly. Responding to these fears, Galen wrote a book for a nonmedical yet well-educated audience with advice on how to choose a doctor.

A square bas-relief with four figures in robes. On the left, a man touches the arm of a boy. On the right, a man stands near the head of a reclining figure.

Votive relief in the shape of a small temple (naiskos) dedicated by Archinos, depicting the healing of a patient. Greek, ca. 380–350 BCE. Marble. Sanctuary of Amphiaraos at Oropos, Greece. H. 49 cm; W. 54 cm. National Archaeological Museum, Athens: 3369. Photo: Irini Miari. © Hellenic Ministry of Culture and Sports / Archaeological Receipts Fund.

According to Galen, a good physician is a follower of Hippocrates. Skill at prognosis—the ability to predict the trajectory of an illness and thus, essentially, to diagnose it, in modern parlance—would give a talented healer an indication of the course of an illness, and this in turn would inform a strategy for how to treat it. Since the Hippocratic Corpus includes descriptions of many trusted therapeutics, a physician well-read in this tradition would have a firm grasp on dietetics, pharmacology, and surgery. Additionally, a qualified doctor would understand the importance of individualized care and adapt his treatment to each specific patient. Galen uses his own practice as an example:

“Not a single day has passed without me showing skill in the art of cases of such dimensions or in similar ways.”

While Galen certainly had a flair for self-promotion, the text was not an advertisement for his services, and he was sincere in his desire to help readers navigate the health care marketplace.

Imperfect circle composed of a dark, greenish-brown metal. Raised, indistinct shapes decorate the center.

Left: Cupping vessel. Roman, 1–79 CE. Bronze. Pompeii. Science Museum, London: A608651. Photo: © The Board of Trustees of the Science Museum. CC BY-SA 4.0.Right: Coin. Reverse: cupping vessel with a pair of medical forceps. 400–344 BCE. Bronze. Minted in Atrax, Thessaly, Greece. Diam. 14 cm; Wt. 2.6 g. British Museum: 1866,1201.4268. Photo: © The Trustees of the British Museum. CC BY-NC-SA 4.0.

He was critical of wealthy patients who could be swayed by flattery, lured by pleasure, or tempted by trends, and who failed to approach the task of selecting a doctor with the gravity it required. Galen advised people to follow prospective physicians on their rounds in order to evaluate their clinical skills, and to quiz them on Hippocratic texts and other ancient writers to assess their learnedness and logic.

Black vessel decorated with orange figures in robes. On the side shown, a standing man extends his arm to a seated man, who grasps it in his hands.

The Clinic Painter. Perfume container (aryballos) depicting a doctor performing a bleeding treatment. Greek, ca. 480–470 BCE. Terra-cotta. Athens. H. 8.8 cm; Diam. 8.6 cm. Musée du Louvre: Peytel Donation, 1914; CA 1989–CA 2183. Photo: © RMN-Grand Palais / Art Resource, NY.

Personal qualities, in addition to technical talent and theoretical knowledge, were important too; a doctor also needed to possess a strong moral character and a special kind of awe-inspiring authority. The involved process of selecting a physician presupposes a reader of a certain class—one with the time, knowledge, and background to invest in such a rigorous audition—but it could be a matter of life and death. 

Written in 178 CE, this text was specifically tailored for the medical scene in Rome, but many of the ideal qualities that Galen describes apply to physicians at any time and in any place. For Galen the ideal doctor-patient relationship was a partnership with the two parties united against disease.